Regional experts and policy makers launch first MENA Heart Failure Alliance, setting out key priorities to tackle the ‘forgotten heart disease’

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The regional event, ‘MENA Heart Failure Roadmap: Closing the gaps in Heart Failure across the Middle East and North Africa’, was held at Park Rotana Hotel, Abu Dhabi on Saturday 26th November

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· Dr. Kamal Alghalayini, Consultant Cardiologist and Director of the Heart Failure Program and Non-invasive Cardiology Lab at King Abdulaziz University, Jeddah – Saudi Arabia · Prof. Feras Bader, Cardiologist, Cleveland Clinic, Abu Dhabi – UAE · Dr. Waleed Al-Habeeb, Secretary General of the Saudi Heart Association and President of the Saudi Heart Failure Group – Saudi Arabia · Dr. Bassem Sobhi, Consultant Cardiologist and Head of the Heart Failure Clinics – National Heart Institute, Cairo- Egypt · Ms. Angela Massouh, a Heart Failure Nurse Specialist, American University of Beirut Medical Center · Mrs. Hend Soliman, Heart Failure Patient and member of the Egyptian Association for Care of Heart Failure Patients, Cairo – Egypt · Mr. Ed Harding: Managing Director Health Policy Partnership (HPP) Consultancy – UK

UAE: The MENA Heart Failure Alliance, the region’s first dedicated group for heart failure management, was launched during a regional experts event held in Abu Dhabi yesterday. The ‘Closing the Gaps in Heart Failure across MENA’ workshop brought together healthcare leaders, policy makers and heart failure experts from across the region to discuss the findings from The MENA Heart Failure Roadmap Report – an in-depth study conducted by The Health Policy Partnership. The report assessed the unmet needs, barriers, and opportunities for policy change that may reduce the morbidity and mortality for MENA heart failure patients.

The MENA Heart Failure Alliance will be dedicated to combat heart failure, establish a clear roadmap of priority actions, and develop locally applicable interventions and policies following the key focus areas identified through the Roadmap Report findings.

uae_infographic-engThe regional event enabled the Alliance to identify key priority areas for heart failure management in MENA and the UAE, which included; raising public, patient and professional awareness and understanding; developing comprehensive and unique national strategies; establishing better measurement and data, and; working on continuous care pathways and guidelines. The Alliance is formed by expert members including, Professor Feras Bader, Cardiologist, Cleveland Clinic Abu Dhabi (UAE), Dr. Bassem Sobhi, Consultant Cardiologist and Head of the Heart Failure Clinic – National Heart Institute, Cairo (Egypt), Dr. Waleed Al-Habeeb,  Secretary General of the Saudi Heart Association and President of Saudi Heart Failure Group (KSA), Dr. Kamal Alghalayini, Cardiology Consultant and Director of the Heart Failure program and non-invasive Cardiology Lab at King Abdulaziz University (KSA), Mrs. Hend Soliman, Heart Failure Patient and member of the Egyptian Association for Care of Heart Failure Patients (Egypt) and Ms. Angela Massouh, a Heart Failure Nurse Specialist, American University of Beirut Medical Center (Lebanon).

Speaking at the heart failure event, Alliance member Dr Prof. Feras Bader, Cardiologist, Cleveland Clinic, Abu Dhabi said:

“The MENA region has one of the youngest populations of heart failure patients across the globe, with the population in MENA developing heart failure 10 years younger than their western counterparts[1]. Furthermore, despite striking improvement in the prognosis and survival in patients with coronary artery disease (CAD), hypertension, and congenital heart disease, the prevalence of heart failure still continues to grow[2]”.

A study conducted by TNS UK in 2014 found that people are generally more afraid of stroke (41%), advanced cancer (43%) or heart attacks (12%) than heart failure (4%), even though heart failure is more deadly[3].

“Awareness of heart failure is low amongst the general public, healthcare professionals and policymakers, which can affect all aspects of heart failure care and there are often limited educational materials and appropriate support to help patients and caregivers understand the condition. This may result in late presentation, inadequate self-care, or limit the patients’ ability to make care or treatment decisions.

“One of the key focus areas for the MENA Heart Failure Alliance, is to work with a cross section of specialist physicians and healthcare providers to increase awareness of the disease and ensure patients and healthcare professionals can make informed decisions.”

Heart Failure often occurs when the heart muscle has suddenly become weak following a heart attack or other illnesses affecting the heart, or by damage sustained more gradually due to diabetes, high blood pressure or coronary artery disease[4],[5]. Common risk factors of heart failure include, high blood pressure, diabetes mellitus, hyperlipidaemia leading to CAD, cigarette smoking and obesity, many of which are associated with a more Western-type lifestyle and presently highly prevalent in the Middle-East population.

Dr Wael Al Mahmeed, Cardiologist at Cleveland Clinic Abu Dhabi and also part of the MENA Heart Failure Alliance said:

“While there are comprehensive healthcare strategies in the region when it comes to cardiovascular disease and non-communicable disease, we need to work with our governments to ensure heart failure is integrated within those frameworks and the region and the UAE is prepared for its expected future burden.”

The Heart Failure Roadmap report found that the MENA region has unique challenges in heart failure that require unique responses. Studies suggest that re-hospitalisation rates are much higher in MENA than in other countries. These may be driven, in part, by inadequate awareness and understanding of heart failure at all levels of the health system and inconsistent patient follow up. These high re-admission rates are costly and often avoidable.

“Accurate and comprehensive data collection on the burden of heart failure in this region will be a top priority for the MENA Heart Failure Alliance as it’s the primary reason why little attention is given to the diagnosis, management and prevention of the disease,”  Dr Wael said

“Heart failure is the number one reason for hospitalisation for people over 65 across the globe7, placing a huge social and economic burden on patients and their families. The pressures of heart failure are set to grow across MENA, driven by the high prevalence of risk factors for non-communicable diseases in the region which are often left unchecked and unchallenged.

“Understanding the sociocultural aspects affecting the disease will help develop locally applicable interventions and policies. Governments must urgently develop responses that are specific to the needs and circumstances of the region and each individual country,” Dr Wael concluded.

Another key point of discussion was how to build continuous care pathways and guidelines for heart failure patients, including; recognising the importance of prevention; achieving timely and accurate diagnosis; ensuring patients receive guideline based care whilst in hospital recognizing the importance of monitoring and maintenance of heart failure outside of hospital and; giving patients adequate tools and support for self-monitoring and self-management.

The MENA Heart Failure Alliance will now begin establishing comprehensive heart failure management programmes across the region to help patients access adequate and more equitable care with the encouraged commitment and consensus among clinicians and policymakers.

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References

  1. Hospitalized heart failure patients with preserved vs. reduced ejection fraction in Dubai, United Arab Emirates: a prospective study, European Journal of Heart Failure (2014) 16, 454–460

  1. Gulf CARE: Heart failure in the Middle East, Glob Cardiol Sci Pract. 2015; 2015(3): 34.Published online 2015 Oct 2, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625206/ (last accessed 8.11.16)

  1. TNS UK Limited, March 2014. Survey of 11,000 members of the public aged 50+ years old in Europe, funded by Novartis Pharmaceuticals

  1. Harrison’s ‘Principles of Internal Medicine’, Seventeenth Edition pages 1442 – 1455

  1. Mosterd A, Hoes, A, Clinical epidemiology of heart failure, Heart 2007;93:1137-1146

  1. Zannad F. et al, Heart failure burden and therapy, Europace 2009, 11;v1-v9